[Obesity and high blood pressure in French West Indies women, some difference according to definition of obesity; BMI or abdominal obesity]. / Obésité et hypertension artérielle chez la femme antillaise, la prévalence diffère selon la définition utilisée, indice de masse corporelle ou tour de taille.

OBJECTIVES: To compare prevalence of abdominal obesity with obesity defined as BMI >or=30 kg/m2 in a West Indies population, and to define the relation between obesity and hypertension. METHODS: A cross-sectional study of 2420 consecutive unemployed subjects referred for check-up in the two health centres of Guadeloupe, a French Caribbean island. Height and weight were measured and the body mass index (BMI) was calculated as weight/height2 (kg/m2). Obesity was defined as BMI >or=30 kg/m2 and excess weight as BMI >or=25 kg/m2 and<30 kg/m2. Abdominal obesity was defined as waist measurement more than 88 cm for women and more than 102 cm for men. RESULTS: [table: see text] CONCLUSION: A high prevalence of obesity was observed in this Caribbean population suggesting the interest of primary prevention in The Caribbean. In women, abdominal obesity (waist measurement>88 cm) was more frequent than obesity defined as BMI>30 kg/m2). In a multivariate analysis, obesity is an independent risk factor of hypertension (Odds-ratio=3), however the definition of obesity.

[Prevalence of hypertension in a disadvantaged population in Antilles: a major role for obesity?]. / Prévalence de l'HTA en population précaire aux Antilles : rôle majeur de l'obésité?

UNLABELLED: The aim of this study was to evaluate the prevalence of hypertension and its management in a disadvantaged population, essentially composed of those receiving state subsidies and the unemployed. METHODS: The PHAPPG study : Prevalence of Hypertension in a Population Précaire Guadeloupéenne (disadvantaged population in Guadeloupe) included 2420 consecutive people considered to be 'disadvantaged' seen in the two medical examination centres in Guadeloupe between November 2001 and November 2003. RESULTS: The prevalence of obesity was considerable throughout the female population of Antilles (29%). It was recorded in 12% of men. The prevalence of hypertension in the population was 24.7% for men and 22.1% for women. Obesity was the main factor that could explain the higher prevalence of hypertension noted in Antilles, especially among 'disadvantaged' women. In effect, after correction for other risk factors and for age, this prevalence of hypertension was on average three times higher amongst the obese compared to subjects with normal weights. CONCLUSION: The prevalence of hypertension is elevated in the population of Antilles, especially among the disadvantaged. Obesity is the key factor, upon which a primary prevention policy for hypertension could be based.

Reducing the burden of arterial hypertension: what can be expected from an improved access to health care? Results from a study in 2420 unemployed subjects in the Caribbean.

High prevalence and poor control of hypertension have been observed in populations with low-socioeconomic status. Comparing an unemployed population with another employed population sharing the same culture, and another employed population living in another environment might enlighten the effects of factors accessible to primary prevention on the one hand and access to health care on the other hand. The objectives are, first, to describe blood pressure (BP) prevalence and control in an unemployed Caribbean population benefiting from State financial support and good access to health care and second, compare the results in this population with those observed, with the same methodology in two employed populations, one in the Caribbean and one in metropolitan France. A cross-sectional study of 2420 consecutive unemployed subjects referred for check-up in the two health centres of Guadeloupe, a French Caribbean island. Hypertension prevalence was 25.2% in men and 22.1% in women. BP was controlled in 17.3% of men and 37.2% of women receiving antihypertensive medication. Among women, 58% were overweight and 29% obese. Prevalence of hypertension was higher among the unemployed and employed Caribbean population, than among an employed metropolitan French population. A high prevalence of obesity was observed in the two Caribbean populations suggesting the interest of primary prevention in the Caribbean. Burden of hypertension in a population relates to the development of hypertension (primary prevention) and control of hypertension (secondary prevention). Identifying hypertensive patients and controlling blood pressure are both important to reduce the disease burden.

[Access to care: not enough to completely abolish the disparity in hypertension management at the socio-economic level]. / Une bonne couverture sociale et un bon accès aux soins: un prérequis nécessaire mais insuffisant pour faire disparaître une disparité de prise en charge de l'HTA selon le niveau socio-économique.

Higher prevalence and poorer control of hypertension have been observed in populations with low socioeconomic status. The causal link between socioeconomic factors and hypertension is complex. What is the impact of medical services compared with other health status determinants? We aimed to assess blood pressure prevalence and control in an unemployed disadvantaged population receiving state financial support and with easy access to health care. This was a cross-sectional study of 2420 consecutive subjects in Guadeloupe, a French Caribbean island, who were referred for check-up in a health centre. As unemployed persons, they all benefited from state financial support and special coverage. Blood pressure was averaged from three consecutive measurements. Subjects not taking antihypertensive medications and with average BP > 140/90 mmHg underwent an additional visit. A total of 1088 men aged 42 +/- 10.6 years and 1332 women aged 40 +/- 11 years were included from November 2001 to November 2003. Hypertension prevalence was 25.2% in men and 22.1% in women, while awareness was 40.2% in men and 73% in women. Blood pressure was controlled (<140/90 mmHg) in 19% of men and 37,2 % of women receiving antihypertensive medication. Among women, 58% were overweight and 29% obese. Hypertension prevalence was slightly higher than that recently observed in cohorts of workers in Caribbean regions and metropolitan France. Control was poorer despite similar awareness and treatment rates. These findings suggest that a universal healthcare system can reduce, but not fully eliminate, disparities in hypertension care and prevalence across income categories.

Obesity in a health center in Guadeloupe (French West Indies). A case control study - Poster abstract

OBJECTIVE: The aim of this study was to assess prevalence of obesity in a health center in Guadeloupe and analyse the association of known cardiovascular risk factors. MATERIAL AND METHODS: From a total of675 people aged 18 to 75 years attending a health centre between April and September 1999, 79 obese patients (BMI> 30) and 158 non-obese age and sex matched controls were enrolled. Pregnant patients were excluded. Medical histories were obtained by standardised questionnaire. Body mass index (BMI), waist to hip ratio (WHR), and laboratory measurements were done. RESULTS: Among the 675 subjects, prevalenceof overweight (BMI>25 and<30) was 35.4 percent) formen vs 38.9 percent for women and prevalence of obesity (BMI >30) was 9.7 percent for men vs 18.6 percent for women. Results in cases and controls are shown in the table. A logistic regression revealed that sedentary way of life, hypertension and a WHR>0.90 were cardiovascular risk factors significantly and independently associated with obesity. CONCLUSIONS: These results have shown a high percentage of overweight subjects for whom it is necessary to organize the prevention of cardiovascular disease by the control of hypertension, dietary restriction and exercise training. (Au)